卵巢癌患者血清人附睾蛋白4、糖类抗原125及甲壳质酶蛋白-40水平与病理特征的相关性

Correlation between serum human epididymis protein 4,carbohydrate antigen 125,human cartilage glycoprotein 39 levels and pathological features in patients with ovarian cancer

目的探讨卵巢癌患者血清人附睾蛋白4(HE4)、糖类抗原125(CA125)及甲壳质酶蛋白-40(YKL-40)水平与其病理特征的相关性。方法选取80例上皮性卵巢癌患者(上皮性卵巢癌细胞组)、40例上皮性卵巢肿瘤良性患者(良性卵巢肿瘤细胞组)及40例健康妇女(对照组)血清,使用酶联免疫吸附法(ELISA)检测血清中HE4、YKL-40含量,使用电化学发光免疫法测定CA125含量。分析血清YKL-40、HE4、CA125诊断卵巢癌的敏感度,并确定血清HE4、CA125和YKL-40最佳界限值。结果对照组、良性卵巢肿瘤细胞组、上皮性卵巢癌细胞组YKL-40、HE4、CA125含量两两比较,差异均有统计学意义(P<0.01)。上皮性卵巢癌患者血清YKL-40含量与病理类型(浆液性、黏液性)、淋巴结转移、病理分级密切相关(P<0.05),血清HE4、CA125含量与病理类型(浆液性、黏液性)、临床分期、病理分级、淋巴结转移密切相关(P<0.05)。YKL-40、HE4、CA125阳性卵巢癌患者生存率均显著低于其对应的阴性卵巢癌患者(P<0.05)。HE4、CA125、YKL-40的最佳临界值分别为101.200 pmol/L、95.200 U/mL、53.600 ng/mL,Youden指数分别为0.852、0.547、0.749。HE4、CA125、YKL-40单独诊断卵巢癌的灵敏度分别为91.5%、87.0%、72.0%,3者联合诊断的灵敏度为96.5%,差异有统计学意义(P<0.05);HE4、CA125、YKL-40单独诊断卵巢癌的特异度分别为92.0%、93.0%、95.0%,3者联合诊断的特异度为85.0%,差异有统计学意义(P<0.05)。结论卵巢癌患者血清HE4、CA125、YKL-40水平与卵巢癌的发生及不良预后密切相关。

Objective To explore the correlation between serum human epididymis protein 4(HE4),carbohydrate antigen 125(CA125),human cartilage glycoprotein 39(YKL-40)levels and pathological features in patients with ovarian cancer.Methods The serum samples of 80 patients with epithelial ovarian cancer(epithelial ovarian cancer cell group),40 patients with benign epithelial ovarian tumor(benign ovarian tumor cell group)and 40 healthy women(control group)were collected.The contents of serum HE4 and YKL-40 were detected by enzyme-linked immunosorbent assay(ELISA),and CA125 content was detected by electrochemiluminescence immunoassay.The sensitivities of serum YKL-40,HE4 and CA125 in the diagnosis of ovarian cancer were analyzed,and the optimal limits of serum HE4,CA125 and YKL-40 were determined.Results For control group,the benign ovarian tumor group and the epithelial ovarian cancer group,there were significant differences in contents of YKL-40,HE4 and CA125 between every two groups(P<0.01).The content of YKL-40 was closely related to pathological type(serous type,mucinous type),lymph node metastasis and pathological grade in patients with epithelial ovarian cancer(P<0.05),and the contents of serum HE4 and CA125 were closely related to pathological type(serous type,mucinous type),clinical stage,pathological grade and lymph node metastasis(P<0.05).The survival rates of ovarian cancer patients with positive results of YKL-40,HE4 and CA125 were significantly lower than those with corresponding negative results(P<0.05).The optimal critical values of HE4,CA125 and YKL-40 were 101.200 pmol/L、95.200 U/mL、53.600 ng/mL respectively,and the Youden indexes were 0.852,0.547 and 0.749 respectively.The sensitivities of HE4,CA125 and YKL-40 were 91.5%,87.0%and 72.0%respectively,the sensitivity of the combined diagnosis was 96.5%,and there were significant differences(P<0.05).The specificities of HE4,CA125 and YKL-40 were 92.0%,93.0%and 95.0%respectively,the specificity of the combined diagnosis was 85.0%,and there were significant differences(P<0.05).Conclusion The levels of serum HE4,CA125 and YKL-40 in patients with ovarian cancer are closely related to the occurrence and poor prognosis of ovarian cancer.